Death before Birth: Fetal Health and Mortality in Historical Perspective

by Robert Woods

Overview

Considering its importance, the history of fetal health and mortality remains a neglected area. Medical historians have tended to focus on maternal mortality and professional conflicts between midwives rather than on the unborn, while among the social scientists demographers and epidemiologists have until recently devoted most of their attention to infants and children. Death before Birth redresses this imbalance, redirecting attention to the fetus. A study of fetal health from the seventeenth century to the present day, it is the first book to offer an historical perspective on the subject and to combine both medical history and epidemiological and demographic research, using long-term and comparative perspectives, including a strong international comparative element, across both Europe and North America. The book not only provides an account of how fetal health and the risks facing the unborn (miscarriages, abortions, stillbirths etc) have changed, it also offers an interpretation of the causes, one that focuses on the role of obstetrics and the epidemiology of maternal infections. Along the way, it pays detailed attention to a host of related themes, such as varying cultural practices in the recognition of stillbirths; the age pattern of mortality risk between conception and live birth; comparative trends in late-fetal mortality and their causes; fetal mortality and obstetric care during the eighteenth, nineteenth, and twentieth centuries; and the contrasting approaches of the pathologists and 'social epidemiologists' to the causes of fetal death. The book concludes with a study of the 'fetus as patient', focusing on issues surrounding the legalization of abortion in many Western countries and the public health challenges of persistently high mortality in less developed countries.

Product Details

ISBN-13:	9780191609220
Publisher:	OUP Oxford
Publication date:	08/27/2009
Sold by:	Barnes & Noble
Format:	eBook
File size:	6 MB

About the Author

Robert Woods was John Rankin Professor of Geography at the University of Liverpool. He was the author of The Demography of Victorian England and Wales (2000) and Children Remembered: Responses to Untimely Death in the Past (2006). He edited the journal Population Studies and was a Fellow of the British Academy.

Table of Contents

List of Figures xi

List of Tables xiv

List of Abbreviations xvi

1 Introduction to fetal health and mortality 1

2 Definitions, measurement, influences 14

Definitions 14

Measurement 27

Influences 30

3 The prospects for survival from conception to childhood 35

Biometric analysis of infant mortality 35

Fetal survival 41

Concepdon-to-first-birthday survival: a model 46

Historical implications 52

4 Comparative historical trends and variations 56

Advanced states 56

Late states 69

Les ondoyés décédés and lesfaux mort-nés 77

Speculations on the causes of decline and convergence since 1930 82

Fetal mortality in developing countries 85

Historical estimation 89

5 Midwifery and fetal death 102

Midwifery before 1750 104

Midwifery practice according to Dr William Smellie 120

Midwifery after Smellie 133

Specialist studies of fetal development and abortion: Whitehead's surveys and Priestley's Pathology 142

6 Fetal pathology and social obstetrics 152

Diseases of the fetus and infant o152

Fetal necropsy 160

Social obstetrics 165

The classification of causes 178

7 Arguments from medical history and demography 189

How should fetal mortality be explained? 190

Arguments from medical history 196

Arguments from demography, etc. 209

Smallpox in pregnancy 213

Maternal syphilis 232

Combined causes 235

8 Induced abortion and the fetus as patient: a continuing paradox 238

Bibliography 257

Index 285

Editorial Reviews

"Deserves to be known as the latest definitive word on the subject for medical historians, demographers, epidemiologists, and economic historians."—Journal of Interdisciplinary History

"An extremely eclectic study that not only seems but actually coheres as a wide-ranging and copiously illustrated exploration of what a methodology for examining fetal health in the past should look like."—American Historical Review

From the Publisher